拉米夫定及恩替卡韦预防和治疗非霍奇金淋巴瘤相关性HBV再激活的疗效对比

倪传斌; 龙波

doi:10.3969/j.issn.1001-5256.2014.04.019

拉米夫定及恩替卡韦预防和治疗非霍奇金淋巴瘤相关性HBV再激活的疗效对比

DOI: 10.3969/j.issn.1001-5256.2014.04.019

倪传斌,
龙波

解放军425医院肝病科

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中图分类号: R512.62
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出版历程
- 收稿日期: 2013-07-11
- 出版日期: 2014-04-20

Clinical comparison of preventive and therapeutic effects of lamivudine and entecavir on HBV reactivation among patients with non- Hodgkin lymphoma

Department of Infectious Diseases, No.425 Hospital of PLA

摘要

摘要:
目的对比观察拉米夫定及恩替卡韦在预防和治疗非霍奇金淋巴瘤(NHL)合并慢性HBV感染的患者化疗期间出现HBV再激活的有效性。方法自2008年1月至2013年4月,共收集NHL合并HBV感染患者94例,分为拉米夫定治疗组和恩替卡韦治疗组,两组化疗同时分别服用拉米夫定(100 mg/d)和恩替卡韦(0.5 mg/d),就组间病毒学突破率,原发性无应答率、病毒学突破相关性肝炎突发等方面进行对比。计量资料2组独立样本用t检验,3组独立样本用单因素方差分析进行比较;计数资料用χ2检验进行组间比较。结果抗HBV治疗前HBV DNA<103拷贝 2="1.03,P">0.05)。抗HBV治疗前HBV DNA>103拷贝/ml组,服用拉米夫定的患者病毒学突破率为37.5%,原发耐药率为9.4%,肝炎突发率28.1%,肝衰竭发生率3.1%;服用恩替卡韦的患者上述指标分别为3.1%、0、0、0,两者病毒学突破率及肝炎突发率均有统计学差异(χ2=11.68、10.47,P<0.05)。结论 NHL合并HBV感染患...
- 淋巴瘤,非霍奇金 /
- 肝炎病毒,乙型 /
- 拉米夫定 /
- 恩替卡韦
Abstract:
Objective To investigate the preventive and therapeutic effects of lamivudine and entecavir on hepatitis B virus (HBV) reactivation among non- Hodgkin lymphoma (NHL) patients with chronic HBV infection during chemotherapy.Methods From January 2008 to April 2013, a total of 94 NHL patients with HBV infection were recruited from our hospital and divided into lamivudine treatment group and entecavir treatment group.The lamivudine treatment group received chemotherapy with lamivudine (100 mg / d) , and the entecavir treatment group received chemotherapy with entecavir (0.5 mg / d) .The rates of virological breakthrough, primary non- response, and virological breakthrough- related hepatitis flare were compared between groups.The t- test was used for comparison between two groups of independent samples;one- way analysis of variance was conducted for comparison between three groups of independent samples;the chi- square test was used to conduct intergroup comparison.Results For the patients with HBV DNA levels lower than 103copies / ml before anti- HBV treatment, no significant difference was found in the rate of virological breakthrough or rate of hepatitis flare between lamivudine treatment group and entecavir treatment group (χ2= 1.03, P > 0.05) .For the patients with HBV DNA levels higher than 103copies / ml before anti-HBV treatment, the lamivudine treatment group had a virological breakthrough rate of 37.5%, a primary non- response rate of 9.4%, a hepatitis flare rate of 28.1%, and a liver failure rate of 3.1%, and the aforementioned rates for entecavir treatment group were 3.1%, 0, 0, and 0, respectively;there were significant differences in the rates of virological breakthrough and hepatitis flare between the two groups (χ2= 11.68, P < 0.05;χ2= 10.47, P < 0.05) .Conclusion Among NHL patients with HBV infection whose HBV DNA levels are lower than 103copies / ml, the preventive and therapeutic effects of lamivudine and entecavir on HBV reactivation are similar;among NHL patients with HBV infection whose HBV DNA levels are higher than 103copies / ml, those treated with entecavir have lower rates of virological breakthrough and hepatitis flare than those treated with lamivudine, which helps patients have a smoother progress of chemotherapy.
- lymphoma, non-Hodgkin /
- hepatitis B virus /
- lamivudine /
- entecavir

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